Dataset Information

Impact of Internet-Based Interventions on Caregiver Mental Health: Systematic Review and Meta-Analysis.

ABSTRACT:

Background

The health of informal caregivers of adults with chronic conditions is increasingly vital since caregivers comprise a large proportion of supportive care to family members living in the community. Due to efficiency and reach, internet-based interventions for informal caregivers have the potential to mitigate the negative mental health outcomes associated with caregiving.

Objective

The objective of this systematic review and meta-analysis was to examine the impact of internet-based interventions on caregiver mental health outcomes and the impact of different types of internet-based intervention programs.

Methods

MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane, and AgeLine databases were searched for randomized controlled trials or controlled clinical trials published from January 1995 to April 2017 that compared internet-based intervention programs with no or minimal internet-based interventions for caregivers of adults with at least 1 chronic condition. The inclusion criteria were studies that included (1) adult informal caregivers (aged 18 years or older) of adults living in the community with a chronic condition; (2) an internet-based intervention program to deliver education, support, or monitoring to informal caregivers; and (3) outcomes of mental health. Title and abstract and full-text screening were completed in duplicate. Data were extracted by a single reviewer and verified by a second reviewer, and risk of bias assessments were completed accordingly. Where possible, data for mental health outcomes were meta-analyzed.

Results

The search yielded 7923 unique citations of which 290 studies were screened at full-text. Of those, 13 studies met the inclusion criteria; 11 were randomized controlled trials, 1 study was a controlled clinical trial, and 1 study comprised both study designs. Beneficial effects of any internet-based intervention program resulted in a mean decrease of 0.48 points (95% CI -0.75 to -0.22) for stress and distress and a mean decrease of 0.40 points (95% CI -0.58 to -0.22) for anxiety among caregivers. For studies that examined internet-based information and education plus professional psychosocial support, the meta-analysis results showed small to medium beneficial effect sizes of the intervention for the mental health outcomes of depression (-0.34; 95% CI -0.63 to -0.05) and anxiety (-0.36; 95% CI -0.66 to -0.07). Some suggestion of a beneficial effect on overall health for the use of information and education plus combined peer and professional support was also shown (1.25; 95% CI 0.24 to 2.25). Overall, many studies were of poor quality and were rated at high risk of bias.

Conclusions

The review found evidence for the benefit of internet-based intervention programs on mental health for caregivers of adults living with a chronic condition, particularly for the outcomes of caregiver depression, stress and distress, and anxiety. The types of interventions that predominated as efficacious included information and education with or without professional psychological support, and, to a lesser extent, with combined peer and psychological support. Further high-quality research is needed to inform the effectiveness of interactive, dynamic, and multicomponent internet-based interventions.

Trial registration

PROSPERO CRD42017075436; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=75436 (Archived by WebCite at http://www.webcitation.org/709M3tDvn).

SUBMITTER: Sherifali D

PROVIDER: S-EPMC6053616 | biostudies-literature | 2018 Jul

REPOSITORIES: biostudies-literature

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Publications

Impact of Internet-Based Interventions on Caregiver Mental Health: Systematic Review and Meta-Analysis.

Sherifali Diana D Ali Muhammad Usman MU Ploeg Jenny J Markle-Reid Maureen M Valaitis Ruta R Bartholomew Amy A Fitzpatrick-Lewis Donna D McAiney Carrie C

Journal of medical Internet research 20180703 7

<h4>Background</h4>The health of informal caregivers of adults with chronic conditions is increasingly vital since caregivers comprise a large proportion of supportive care to family members living in the community. Due to efficiency and reach, internet-based interventions for informal caregivers have the potential to mitigate the negative mental health outcomes associated with caregiving.<h4>Objective</h4>The objective of this systematic review and meta-analysis was to examine the impact of int ...[more]

PMID: 29970358

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Project description:BACKGROUND:Mental disorders are highly prevalent and associated with considerable disease burden and personal and societal costs. However, they can be effectively reduced through prevention measures. The Internet as a medium appears to be an opportunity for scaling up preventive interventions to a population level. OBJECTIVE:The aim of this study was to systematically summarize the current state of research on Internet-based interventions for the prevention of mental disorders to give a comprehensive overview of this fast-growing field. METHODS:A systematic database search was conducted (CENTRAL, Medline, PsycINFO). Studies were selected according to defined eligibility criteria (adult population, Internet-based mental health intervention, including a control group, reporting onset or severity data, randomized controlled trial). Primary outcome was onset of mental disorder. Secondary outcome was symptom severity. Study quality was assessed using the Cochrane Risk of Bias Tool. Meta-analytical pooling of results took place if feasible. RESULTS:After removing duplicates, 1169 studies were screened of which 17 were eligible for inclusion. Most studies examined prevention of eating disorders or depression or anxiety. Two studies on posttraumatic stress disorder and 1 on panic disorder were also included. Overall study quality was moderate. Only 5 studies reported incidence data assessed by means of standardized clinical interviews (eg, SCID). Three of them found significant differences in onset with a number needed to treat of 9.3-41.3. Eleven studies found significant improvements in symptom severity with small-to-medium effect sizes (d=0.11- d=0.76) in favor of the intervention groups. The meta-analysis conducted for depression severity revealed a posttreatment pooled effect size of standardized mean difference (SMD) =-0.35 (95% CI, -0.57 to -0.12) for short-term follow-up, SMD = -0.22 (95% CI, -0.37 to -0.07) for medium-term follow-up, and SMD = -0.14 (95% CI, -0.36 to 0.07) for long-term follow-up in favor of the Internet-based psychological interventions when compared with waitlist or care as usual. CONCLUSIONS:Internet-based interventions are a promising approach to prevention of mental disorders, enhancing existing methods. Study results are still limited due to inadequate diagnostic procedures. To be able to appropriately comment on effectiveness, future studies need to report incidence data assessed by means of standardized interviews. Public health policy should promote research to reduce health care costs over the long term, and health care providers should implement existing, demonstrably effective interventions into routine care.

Project description:BackgroundApproaches to support the health and well-being of family caregivers of adults with chronic conditions are increasingly important given the key roles caregivers play in helping family members to live in the community. Web-based interventions to support caregivers have the potential to lessen the negative health impacts associated with caregiving and result in improved health outcomes.ObjectiveThe primary objective of this systematic review and meta-analysis was to examine the effect of caregiver-focused, Web-based interventions, compared with no or minimal Web-based interventions, on caregiver outcomes. The secondary objective was to assess the effect of different types of Web-based interventions (eg, education, peer and professional psychosocial support, and electronic monitoring of the care recipient), compared with no or minimal Web-based interventions, on caregiver outcomes.MethodsMEDLINE, EMBASE, CIHAHL, PsychInfo, Cochrane, and AgeLine were searched from January 1995 to April 2017 for relevant randomized controlled trials (RCTs) or controlled clinical trials (CCTs) that compared caregiver-focused, Web-based intervention programs with no or minimal Web-based interventions for caregivers of adults with at least one chronic condition. Studies were included if they involved: adult family or friend caregivers (aged ?18 years) of adults living in the community with a chronic condition; a caregiver-focused, Web-based intervention of education or psychosocial support or electronic monitoring of the care recipient; and general caregiver outcomes (ie, burden, life satisfaction, self-efficacy or mastery, reaction to problem behavior, self-esteem, strain, and social support). Title and abstract as well as full-text screening were completed in duplicate. Data were extracted by a single reviewer and verified by a second reviewer, and risk of bias assessments were completed accordingly. Where possible, data for these caregiver outcomes were meta-analyzed.ResultsThe search yielded 7927 unique citations, of which 294 studies were screened at full text. Of those, 14 studies met the inclusion criteria; 12 were RCTs and 1 study was a CCT. One study used an RCT design in 1 country and a CCT design in 2 other countries. The beneficial effects of any Web-based intervention program, compared with no or minimal Web-based intervention, resulted in a mean increase of 0.85 points (95% CI 0.12 to 1.57) for caregiver self-esteem, a mean increase of 0.36 points (95% CI 0.11 to 0.62) for caregiver self-efficacy or mastery, and a mean decrease of 0.32 points (95% CI -0.54 to -0.09) for caregiver strain. However, the results are based on poor-quality studies.ConclusionsThe review found evidence for the positive effects of Web-based intervention programs on self-efficacy, self-esteem, and strain of caregivers of adults living with a chronic condition. Further high-quality research is needed to inform the effectiveness of specific types of Web-based interventions on caregiver outcomes.Trial registrationPROSPERO CRD42018091715; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=91715 (Archived by WebCite at http://www.webcitation.org/738zAa5F5).

Project description:INTRODUCTION:The effects of interventions targeting weight loss on physical health are well described, yet the evidence for mental health is less clear. It is essential to better understand the impact of weight management interventions on mental health to optimise care and minimise risk of harm. We will assess the effect of behavioural weight management interventions on mental health in adults with overweight and obesity. METHODS AND ANALYSIS:The systematic review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. We will include behavioural weight management interventions with a diet and/or physical activity component focusing on weight loss for adults with a body mass index ?25?kg/m2. Randomised controlled trials (RCTs) and cluster RCTs will be the only eligible study designs. Outcomes of interest will be related to mental health. The following databases were searched from inception to 07 May 2019: MEDLINE, Embase, Cochrane database (CENTRAL), PsycINFO, ASSIA, AMED and CINAHL. The search strategy was based on four concepts: (1) adults, defined as ?18 years, with overweight/obesity, defined as BMI ?25kg/m², (2) weight management interventions, (3) mental health outcomes and (4) study design. The search was restricted to English-language published papers, with no other restrictions applied. Two stage screening for eligibility will be completed by two independent reviewers, with two independent reviewers completing data extraction and risk of bias assessment. Data permitting, a random-effects meta-analysis of outcomes, subgroup analyses and meta-regression will be conducted. If not appropriate, narrative synthesis and 'levels of evidence' assessment will be completed. ETHICS AND DISSEMINATION:Ethical approval is not required as primary data will not be collected. The completed systematic review will be disseminated in a peer-reviewed journal, at conferences and contribute towards the lead author's PhD thesis. PROSPERO REGISTRATION NUMBER:CRD42019131659.

Dataset Information

Impact of Internet-Based Interventions on Caregiver Mental Health: Systematic Review and Meta-Analysis.

Background

Objective

Methods

Results

Conclusions

Trial registration

Publications

Impact of Internet-Based Interventions on Caregiver Mental Health: Systematic Review and Meta-Analysis.

Similar Datasets

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